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Abstract

Objective To explore the predictive value of MRI parameters
and tumour characteristics before neoadjuvant chemotherapy
(NAC) and to compare changes in tumour size and
tumour apparent diffusion coefficient (ADC) during treatment,
between patients who achieved pathological complete
response (pCR) and those who did not.
Methods Approval by the Regional Ethics Committee and
written informed consent were obtained. Thirty-one patients
with invasive breast carcinoma scheduled for NAC were
enrolled (mean age, 50.7; range, 37–72). Study design
included MRI before treatment (Tp0), after four cycles of
NAC (Tp1) and before surgery (Tp2). Data in pCR versus
non-pCR groups were compared and cut-off values for pCR
prediction were evaluated.
Results Before NAC, HER2 overexpression was the single
significant predictor of pCR (p=0.006). At Tp1 ADC,
tumour size and changes in tumour size were all significantly
different in the pCR and non-pCR groups. Using
1.42×10−3 mm2/s as the cut-off value for ADC, pCR was
predicted with sensitivity and specificity of 88% and 80%,
respectively. Using a cut-off value of 83% for tumour
volume reduction, sensitivity and specificity for pCR were
91% and 80%.
Conclusion ADC, tumour size and tumour size reduction at
Tp1 were strong independent predictors of pCR.